Individual
MR. CASEY LENN WIGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS OTR L
Contact information
Practice address
525 S 3RD ST STE C, GADSDEN, AL 35901-5350
(256) 543-1066
Mailing address
64 HILLVIEW AVE, BOAZ, AL 35957-6625
(256) 738-9171
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
72142875
LA
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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